09070190 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10150 CALVERT DR CONTRACTOR:FIRST AIR HEATING AND PERMIT NO:09070190
AJC
0—NER'S NAME: ALLSTAR FINANCIAL 1510 FELTON RD DATE ISSUED:07/28/2009
0..NER'S PHONE: 4089368606 WILPITAS,CA 95035 PHONE NO:(408)422-3729
❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class 6-20 Lic.#
I, `766 J MECH � RESIDENTIAL rxCOMMERCIAL�
Contractor �l�u/� Kv�_,Date �—GX�/
1 hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:INSTALL HEATING&A/C UNIT;FINISH UNITS
(commencing with Section 7000)of Division 3 of the Business&Professions LOOK UP;
Code and that my license is in full force and effect. IRST AIR HEATING RENWD BUS LIC 7/28/9 WITH
INANCE
1 hereby affirm under penalty of perjury one of the following two declarations:
1 have and will maintain a certificate of consent to self-insure for Worker's
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code,for the performance of the work for which this iq,Ft Floor Area: Valuation:$5500
permit is issued.
APPLICANT CERTIFICATION CPN Number:37519022.00 Occupancy Type:
I certify that I have read this application and state that the above information is
correct. I agree to comply with all city and county ordinances and state laws relating
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save PERMIT EXPIRES IF WORK IS NOT STARTED
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION.
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18. n
store _Date J �U Issued ' Date:
❑ OWNER-BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOFS:
\II roofs shall be inspected prior to any roofing material being installed.If a roof is
the following two reasons: nstalled without first obtaining an inspection,I agree to remove all new materials for
I,as owner of the property,or my employees with wages as their sole compensation, nspection.
will do the work,and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code) ;ignature of Applicant: Date:
I,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code).
ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
I hereby affirm under penalty of perjury one of the following three
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE
Compensation,as provided for by Section 3700 of the Labor Code,for the have read the hazardous materials requirements under Chapter 6.95 of the
performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. 11 will maintain
I have and will maintain Worker's Compensation Insurance,as provided for by -ompliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
Section 3700 of the Labor Code,for the performance of the work for which this :safety Code,Section 25532(a)should I store or handle hazardous material.
permit is issued. additionally,should 1 use equipment or devices which emit hazardous air
I certify that in the performance of the work for which this permit is issued,I shall ''ontaminants as defined by the Bay Area Air Quality Management District 1 will
naintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
not employ any person in any manner so as to become subject to the Worker's lealth&Safety Code,Sections 25505,25533,and 25534.
Compensation laws of California. If,after making this certificate of exemption,1
become subject to the Worker's Compensation provisions of the Labor Code,I mus caner tho ized rt: �J•
forthwith comply with such provisions or this permit shall be deemed revoked. Date:�`�/
APPLICANT CERTIFICATIONONSTRUCTION LENDING AGENCY
I certify that I have read this application and state that the above information is hereby affirm that there is a construction lending agency for the performance of work's
correct. I agree to comply with all city and county ordinances and state laws relating or which this permit is issued(Sea 3097,Civ C.)
to building construction,and hereby authorize representatives of this city to enter sender's Name
V 'ie above mentioned property for inspection purposes.(We)agree to save
it nify and keep harmless the City of Cupertino against liabilities,judgments, sender's Address
costs,and expenses which may accrue against said City in consequence of the
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section ARCHITECT'S DECLARATION
9.18• understand my plans shall be used as public records.
Signature Date icensed Professional
CITY OF CUPERTINO
7 ITEMS OF 7 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk : Lot :
APN 37519022 . 00
DATE ISSUED. . . . . . . : 07/28/2009
RECEIPT #. . . . . . . . - : BSC00008296
REFERENCE ID # . . . : 09C70190
SITE ADDRESS . . . . . : 10150 CALVERT DR
SUBDIVISION . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . .
OWNER ALISTAR FINANCIAL
ADDRESS 10150 CALVERT
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : FIRST AIR HEATING
CONTRACTOR . . . . . . . : SAN[ PHONG LIC # 29220
COMPANY FIF.ST AIR HEATING AND A/C
ADDRESS 4510 FELTON RD
CITY/STATE/ZIP . . . : MIIPITAS, CA 95035
TELEPHONE (4C8) 422-3729
FEE ID UNIT QUANTITY IMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- -- -------- ---------- ---------- ----------
1BCBSC VALUATION 5, 500 . 00 1 . 00 0 . 00 1 . 00 0 . 00
1BSEISMICR VALUATION 5, 500 . 00 0 . 60 0 . 00 0 . 60 0 . 00
1EPERMITFE FLAT RATE 1 . 00 42 . 00 0 . 00 42 . 00 0 . 00
1MPERMITFE FLAT RATE 1 . 00 42 . 00 0 . 00 42 . 00 0 . 00
1MRRAA UNITS 2 . 00 126 . 00 0 . 00 126 . 00 0 . 00
1PPERMITFE FLAT RATE 1 . 00 42 . 00 0 .00 42 . 00 0 . 00
1TRAVDOC FLAT RATE 1 . 00 42 . 00 0 . 00 42 . 00 0 . 00
-- -------- ---------- ---------- ----------
TOTAL PERMIT 295 . 60 0 . 00 295 .60 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 295 .60 VISA
---------------
TOTAL RECEIPT 295 . 60
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL
Iowa*
CITY OF CUPERTINO
FUR?4ACE/AC OqL�7 u)
CUPEkTINO PERMIT APPLICATION FORM
APN # (� � �� � �j Date:
l ,
Building Address:
Owner's Name: Doa- 1 Phone#: 7 56 1�'6
Lt A"cf
Contractor: "" t ,j� �� /jjy hone#; (,p/ (��"�_� 12�
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Fax#: �q
Contractor License#: —76 62 P Cupertino Business License#:
Contact: 04-14 - Phone#: 7 o(S- V 2, r 7z
Fax#:
Building Permit Info:
Elect ®---- Plumb Mech
Residential Commercial ❑
Job Descri tion: " S ��, u�� "�541-
V "`'If 5 /A,-�c�-Ci
For Residential Installations:
Attic ❑ 1St floor U2nd floor ❑
Adhere to minimum setback requirement ❑
For Commercial Installations:
Replacement same weight ❑ Additional weight(structural calcs) ❑
Structural Calculations required for new installation ❑
New installation Planning Approval Required ❑
Cost of Project: o , o e, Type of Construction (Usage Class): S- L -9 g-W, 1 k
Strapped ❑ On Platform Bond.-d New Location � Replacement
Project Size: Express ❑ Standard Large [] Major ❑
Valuation:
Green Building: Please complete relevant portion of the Green Building Checklist & attach it to the
application or if applicable, include in plan set & the sheet index.
Revised 01/07/09
CITY OF CUPERTINO
FUR?4ACE/AC
CUPEkTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
1MRAPPVNT Residential for the install/relocate/or M
replacement of ea appliance vent
install ¬ incl in an appl permit.
FURNACE FURN/AC
1 PGASRES Residential for ea gas piping system of P
1-4 Outlets
1BPGAS For each gas piping system of 5 or P
more per outlet.
1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT
TYPES
1BSEISMICR Residential Se.smic B
' P-90\
1MECPLNCK Mechanical PI in Check M
1 MFR=<100 Furnace Syst =100k BTU install or M
relocate ea for,ed-air/gravity type
furnace/burner, incl ducts/vents
attached to such appliance up to and
include 100,0(,0 Btu/h
1MFRN>100 Furnace Syst 100k BTU install or M
relocate ea for;ed-air/gravity type
furnace/burnei, incl ducts/vents
attached to such appliance over
100,000 Btu/h
1 EPERMITFEE Electric Permit Fee E
1MPERMITFEE Mechanical Pcrmit Fee M
1 PPERMITFEE Plumbing Permit P
1TRAVDOC Travel Documentation B
1BUSLIC Business License B
a
CITY OF C;UPERTINO
OF FURNACE/AC
CUPEkTINO FEE SCHEDULE
Quantity Fee ID Fee Descriptio n Fee Permit Type
Group
AIR FURN/AC
CONDITIONING
1 BCAIRHAN Commercial A/C Units <= l Ok CFM B
1 MCRAA Commercial Mec.h Repair/alt/add M
1 BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT
TYPES
1 BSEISMICO Seismic Commercial B
1PGASCOM Commerical for oa gas piping System P
1-4 outlets
1 PGASRES Residential for ea gas piping system P
of 1-4 Outlets
1BPGAS For each gas pi:,)ing system of 5 or P
more per outlet. Comm/Resid
1BREMAIRHAN Residential A/C -znits<= IOk CFM B
/ 1MRRAA Residential Mecic Repair/alt/add M
1BCBSC Cal Bldg Standaids Commission Fee B ALL PERMIT
TYPES
1 BSEISMICR Seismic Resident ial B
f 1 EPERMITFEE Electric Permit E
l 1 MPERMITFEE Mechanical Penrnit M
1PPERMITFEE Plumbing Permit P
1 TRAVDOC Travel Documen ration B
1BUSLIC Business License B
M.Indoor Air Quality and Finishes INPUT Resources Energy IAD!Healthi I
1.Useizw#4o-VOG Paint 1 IAQ/Health pts y=yes 0
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes 0
3.Use Low&VOC Adhesives 3 IAQ/Health pts y=yes 0
4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes 0
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 61AQ/Health pts y=yes 0
0
6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes
7. "all b iPar clebc�ard or ACDF 41AQ/Health. pts y=yes 0
8.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0
9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0
10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes 0
N.Flooring
1.Select FSC Certified Wood Flooring is Resource pts y=yes 0
2.Use Rapidly Renewable Flooring Materials [Resource pts y=yes 0
3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 0
4.Install Natural Linoleum in Place of Vinyl ;IAQ/Health pts y=yes 0
5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0
6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0
Total Points Available: 1 1401 1301 57
- ---- ---- -- --------
Total Points Project Received: 01 0 0
C
G:data/progslgree ibuildngguidelmes/remodelers/greenpointsfinal2.12.04proteoted.xls
w+ Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
„MkTINO
Building Department �-7
JO,B ADDRESS: PERMIT #
5-o C�
_
-
WNER'S NAME: PHONE # V08 -
GENERAL CONTRACTOR: - FAX #
I am not using any subcontractors: 7 �
Si mature Date
Please check applicable subcontractors and comiAete the following information:
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
Linoleum/ Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date